***Check or money order also accepted.
Make check payable to : Alex's Place
Mail to: 8322 Park Road
Batavia, New York 14020
Allow 1 week for delivery
$5
$20
$25
$30
$40
$50
$100
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
Amount
How Many
Billing info:
VISA
Mastercard
Discover
American Express
Diners Club
Credit Card
Card Holder Name
Card Number
Expiration Date
Shipping:
Name
Address
Address (cont)
City
AL
AK
AZ
AR
CA
CO
DE
DC
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
State/Province
Zip/Postal Code